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'Ask me why I don't have nipples': How young adults disclose their cancer status to dates and employers

Philadelphia Inquirer - 8/6/2019

Aug. 6--Dani Bennov's dating profile on OkCupid, Hinge, and Bumble invites people to start an unexpected conversation. "Ask me why I don't have nipples anymore!" it reads.

The 26-year-old breast cancer survivor wants potential partners to know about her cancer diagnosis and treatment from the start.

"I don't want to lure anybody into something they're not ready to handle," said Bennov, who is a young advocate with Living Beyond Breast Cancer, a nonprofit based in Bala Cynwyd.

But when it comes to job hunting, Bennov, who lives in University City, is more reserved, bringing up her cancer diagnosis only if it's necessary to honestly answer an interview question.

Josh Orlow takes the opposite approach. The Old City resident, who was diagnosed with testicular cancer at age 29, writes directly on his resume that he "took a year off for successful cancer treatment" while in graduate school.

Yet in dating, he waits several months before discussing his medical background.

"It's just a hard thing to do," said Orlow, now 35. "It's not a light conversation topic."

For young adults who are fairly new to both careers and relationships, figuring out when and how to tell an employer or a partner about a cancer diagnosis is a complex process. There's the uncertainty of how people will react, and the fear of being overlooked for a job or rejected by a romantic interest. Most survivors agree there's no perfect time or method to tell someone, but it can help to find humor in an otherwise distressing process.

"If you don't laugh about it, you're just going to sit there and cry," Bennov said. So she makes jokes about fake breasts and invites her friends to do the same. (Bennov opted not to receive implants after her double mastectomy last year.)

Bennov believes that her frank attitude might be causing her to get ghosted on dating apps or passed over for a job, but "what happened to me really transformed me as a person," she says. "I want to be honest and transparent about that."

There is no rule book for when to tell a partner about your medical history, said Jean Rowe, a certified oncology social worker and associate director of support services for Young Survival Coalition, a group that focuses on women under 40 with breast cancer. "Everyone has to find what works for them."

For Bennov, being upfront with dates about her cancer history serves a practical purpose. "I don't have nipples and I don't plan on reconstructing them," she said. "So I need to tell them before I take my shirt off."

But it's also about alerting people to her unique needs in a relationship. Chemotherapy has put Bennov in early menopause, causing vaginal dryness and low libido. Parts of her body are scarred or numb from surgery.

"My body is very new," she said. "I'm still trying to figure it out, and I want to meet someone who is willing to help me discover it again."

Body image is one of the biggest challenges for young cancer survivors, Rowe said. Many are angry that this happened to them. Others feel unattractive or depressed that things can't be the way they were before.

"The first person they have to reestablish intimacy with is themselves," Rowe said. Then consider bringing in a partner, she suggested.

Orlow agrees with the idea of taking it slowly.

"In relationships, there are so many factors to consider," he said. "Will that person be accepting? Will I be able to have children? How will this affect our future? It's OK to just start with casual dates and not worry about this serious conversation till later."

Orlow told his now fiancée four months after they met. They were sitting on the couch at his apartment one afternoon, when he said, "Hey, I have something important to tell you."

"By that point in a relationship, you're comfortable with this person and you've gotten to know them," Orlow said. "It strengthens your relationship to be even more honest and let them get to know you more."

While a long-term partner might be more understanding, not everyone reacts well to the news, said Dakota Fisher-Vance, co-founder of Young Adult Cancer Connection, a Philly-based group that brings together cancer survivors in their 20s and 30s.

When Fisher-Vance told a guy she was dating that she survived colon cancer at 22, he said he could relate because he takes medication for insomnia. People often try to make comparisons, she said, but it usually makes things worse. Her date also listed people he knew who died of cancer, she said, recalling her disbelief at his reaction. Another guy pulled back while they were kissing to ask whether she was contagious.

"It's a really rough experience," said Fisher-Vance, who is now 30. But she says being a cancer survivor has given her a unique sense of humor. She now shares these stories as funny anecdotes at Young Adult Cancer Connection meetups.

Others have their own battle stories to share. One of Fisher-Vance's favorite stories is about a woman who had not disclosed her cancer diagnosis to her date, but was forced to explain when he put his arm around her shoulder and accidentally pulled off her wig.

"At some point, you just have to laugh with the mortification of it all," Fisher-Vance said.

When it comes to disclosure during the job-hunting process, there are some rules people should be aware of, said Rebecca Nellis, executive director of the nonprofit Cancer and Careers.

The Americans with Disabilities Act prohibits employers from asking people about their medical histories, so you are never compelled to disclose your diagnosis. But if people want workplace accommodations, they need to provide enough information to justify the need, Nellis said. And with about two in three cancer patients working during treatment, disclosure often becomes necessary.

Bennov has been searching for a job in program management and development since March, when she felt strong enough to return to work. She typically avoids mentioning her diagnosis in interviews, but many times it has come up anyway -- initially because she was bald from the side effects of chemo and more recently because employers have asked about the one-year gap on her resume.

She hasn't made it past any first interviews.

Although that could be for a number of reasons -- maybe they want someone with more experience, maybe it's not a good personality fit -- Bennov said it often feels as if her cancer history puts her at a disadvantage.

"No company will say they didn't hire you because of this," she said. But she worried they thought of her as a liability.

"I'd raise their health insurance rates or I'd need days off. ... Why hire someone sick or who could become sick again when they can hire an able-bodied person?" Bennov said.

Discrimination is difficult to prove in individual cases, Nellis said, but research studies have found that applicants who disclose a cancer history receive fewer callbacks from managers. Employers are 26% less interested in candidates who disclose a disability in their cover letter, according to a 2017 study published in Cornell University's Industrial and Labor Relations Review.

If you must disclose, Nellis advises combining the information about a cancer diagnosis with an example of a lesson the experience taught you or a skill you bring to the job.

"That last thing you're talking about is not the resume gap, but a skillset," she said. "It's about spinning your story to help sell you to the job like anyone else who is applying."

When Orlow graduated from the University of the Sciences with a graduate degree in physical therapy, he didn't want to disclose his diagnosis on his resume. But believed that he had no choice.

Physical therapy programs typically last three years. Orlow took four. "I was nervous about not giving a reason," he said. "I didn't want an employer to think I was on academic probation."

It turned out that employers in the medical field were understanding. Some even valued Orlow's ability to empathize with patients better.

"It was not as big a deal as I thought it would be," said Orlow, who is now a physical therapist at Pennsylvania Hospital.

Still, he tells other cancer survivors not to disclose unless they must.

If you choose that route, Nellis said, make sure you're consistent.

Many applications will ask people to volunteer such demographic information as race, disability, and veteran status. If you check "prefer not to say" on one, do it on all of them, Nellis said. Otherwise it will raise questions.

Also, be careful of what employers can surface with a Google search. Some survivors ask relatives to take down social media posts related to their diagnosis when they enter the job market.

"So much of a person's cancer experience is out of their control," Nellis said. "But their story, their disclosure, can be in their control if that's important to them."

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(c)2019 The Philadelphia Inquirer

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